| NPI | 1093971038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-00180) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0102202623) |
| 207Q00000X Family Medicine (Licence: VA 0116020619) | |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2021-03-11 |